Anastasopoulos Nikolaos-Andreas, Papalois Vassilios
Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, W12 0HS, UK.
Department of Medicine, Faculty of Health Sciences, University of Ioannina, Ioannina, 45 110, Greece.
J R Soc Med. 2022 Jun;115(6):213-219. doi: 10.1177/01410768221095242. Epub 2022 May 3.
Clinical practice has inadvertently changed after the COVID-19 pandemic and currently the need to provide sustainable surgical services is more pressing than ever. The National Health Service has committed to a long-term efficient plan to reduce carbon footprint but there is no detailed plan for surgical practice, the domain that contributes the most to hospital-derived pollution. A series of consecutive steps and measures ought to be taken, starting from a hybrid approach quantifying surgically attributed carbon footprint. Then, a variety of suggested measures can be widely discussed and accordingly applied on a wider or more local level. Appropriate training should always precede implementing new practices to ensure that staff is familiar with these. These measures cover a broad range and should be arranged on a patient-centred basis from preoperative preconditioning to an effective follow-up. The need for more intense research and implementation of enhanced recovery protocols is widely discussed. Also, the necessity of green research and reinvestment of materials and resources is highlighted. A change of philosophy from a cradle-to-grave approach to a repurposing approach is suggested. We are confident that a new era is dawning in surgical practice and teamwork is the key for providing greener surgical services.
在新冠疫情之后，临床实践已在不经意间发生了变化，目前提供可持续手术服务的需求比以往任何时候都更加紧迫。国民医疗服务体系已致力于制定一项长期高效计划以减少碳足迹，但对于手术实践这一医院污染最大来源领域，却没有详细计划。应当采取一系列连续的步骤和措施，从采用混合方法量化手术产生的碳足迹开始。然后，可以广泛讨论各种建议措施，并相应地在更广泛或更局部的层面上应用。在实施新做法之前，始终应进行适当培训，以确保工作人员熟悉这些做法。这些措施涵盖范围广泛，应从术前预处理到有效的随访，以患者为中心进行安排。广泛讨论了对强化康复方案进行更深入研究和实施的必要性。此外，还强调了绿色研究以及材料和资源再投资的必要性。建议从从摇篮到坟墓的方法转变为重新利用的方法。我们相信，手术实践的新时代正在到来，团队合作是提供更绿色手术服务的关键。
